Individual
MARK E BRICKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
202 E UPHAM ST, MARSHFIELD, WI 54449-1543
(715) 384-9050
Mailing address
601 S 32ND AVE, WAUSAU, WI 54401-3958
(715) 848-2526
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3357-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38896200
—
WI
01
—
46586
SECURITY HEALTH PLAN
—
01
—
CH1675
RAILROAD MEDICARE GROUP
—
Enumeration date
09/15/2006
Last updated
12/14/2007
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